Facility Evaluation Report

On 10/1/21 at 10:30 AM, Licensing Program Analyst (LPA) Malia Thao arrived unannounced to conduct an Annual inspection. LPA explained reason for inspection and was granted entry by staff. Licensee (LIC) Din afay Crandell arrived a short time later.

LPA toured inside and outside of facility. Facility was observed clean and without any obstructions or fire clearance issues. Hand sanitizer was readily available to residents and visitors. Social distancing is maintained in the common and dining areas. Hand washing posters were observed by sinks. Residents each have a private room. LPA checked residents’ medications and observed the month's supply. Food supply was observed in adequate supply. Cleaning and PPE supplies were checked. Residents files have updated emergency contact information. Administrator certification is current.

The following forms are to be submitted to CCL within 2 weeks:

LIC610D, LIC500, LIC400, LIC402, letter from second property owner, LIC308

Exit interview was conducted. A copy of this report will be sent to email on record with "Read receipt" to confirm receipt of this report.